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Saudi man has third vCJD case found in US

Dec 5, 2006 (CIDRAP News)  A third case of variant Creutzfeldt-Jakob disease (vCJD) has been reported in a US resident, but health officials believe he contracted the disease in Saudi Arabia when he was a child.

The patient is a young man who has lived in the United States since 2005 but was born and raised in Saudi Arabia, according to a Nov 29 report from the Centers for Disease Control and Prevention (CDC). The man occasionally stayed in the United States for up to 3 months at a time since 2001 and made a shorter visit in 1989.

The brain-wasting disease is believed to be caused by eating meat products from cattle infected with bovine spongiform encephalopathy (BSE), or mad cow disease.

The diagnosis was confirmed in late November by the Clinical Prion Research Team at the University of California San Francisco Memory and Aging Center, the CDC said. Researchers based their findings on study of the man's adenoid and brain biopsy tissues.

CDC officials declined today to list the man's condition or other details, citing his family's request for privacy.

The CDC said the man has no history of receiving blood, having neurosurgery, or living in or visiting European countries. The view that he was probably exposed during childhood is based on the record of a previously reported Saudi case-patient who was thought to have consumed BSE-contaminated meat in Saudi Arabia and on the fact that the incubation period for food-related vCJD is longer than 7 years, the agency said.

"This US case-patient was most likely infected from contaminated cattle products consumed as a child when living in Saudi Arabia," the CDC said.

The previous case of vCJD in a resident of Saudi Arabia was described in a 2005 Emerging Infectious Diseases (EID) report. The 33-year-old man was hospitalized in Saudi Arabia, and his brain biopsy specimen was sent to the US National Prion Disease Surveillance Center at Case Western Reserve University for confirmation. The report said the patient might have briefly visited the United Kingdom, though he likely contracted the disease in Saudi Arabia after eating BSE-contaminated cattle products imported from the United Kingdom.

The two previous vCJD cases in the United States involved people who were thought to have contracted the disease in their native Britain during the country's BSE outbreak in the 1980s and 1990s. One was a 30-year-old man who lived in Houston for 4 years before he was diagnosed with vCJD in 2005. The other was a 25-year-old woman who died in Ft Lauderdale in 2004; she had moved from England to Florida with her father in 1992. Neither patient was known to have had invasive procedures or have received blood, both of which are other possible transmission routes for vCJD.

According to the CDC, 200 people with vCJD have been reported worldwide, including 164 diagnosed in the United Kingdom, 21 in France, 4 in Ireland, 3 in the United States (including the current patient), 2 in the Netherlands, and 1 each in Canada, Italy, Japan, Portugal, Saudi Arabia, and Spain. Of all reported vCJD patients, all but 10 had lived either in the United Kingdom or France for at least 6 months between 1980 and 1996.